腹腔镜辅助下阴式子宫切除67例临床分析

A clinical analysis on laparoscopic-assisted vaginal hysterectomy in 67 patients

目的探讨腹腔镜辅助下阴式子宫切除术（LAVH）的临床应用价值。方法对LAVH67例和同期行传统经腹全子宫切除术（TAH）68例患者的临床资料进行回顾性分析。比较两组患者的手术时间、出血量、术后下床时间、肛门排气时间、术后发热、住院天数、术后随访情况是否存在差异。结果①两组手术时间比较差异无统计学意义（P〉0．5）；②LAVH出血量（116．57±37．32）m1，术后下床活动时间（23．06±4．47）h，肛门排气时间（21．06±4．52）h，术后发热3例（4．5％），住院天数（7．55±0．68）天，与TAH比较，差异有统计学意义（P〈0．05）；③术后随访两组患者阴道残瑞愈合良好，盆腔B超无异常。结论LAVH具有开腹手术及阴式手术共同的优点，优于传统的经腹全子宫切除术，在临床上具有更大的发展空间。

Objective To explore the clinical values of laparoscopic-assisted vaginal hysterectomy （LAVH）. Methods The clinical data on 67 patients who had undergone LAVH and 68 patients who had received traditional total abdominal hysterectomy （TAH） at the same period were retrospectively analyzed. Surgical duration, hemorrhage amounts, time to postoperative activity, time to anal aerofluxus, postoperative fever, length of hospital stay, and postoperative follow-up were compared betweeen the two groups. Results The difference in surgical durations between the two groups was not statistically significant （P〉0.5）. In the LAVH group, the hemorrhage amount was （116.57 ±37,32） ml, time to postoperative activity was 23.06 ± 4.47 h, time to anal aerofluxus was （21.06± 4.52） h, three patients （4.5%） occurred postoperative fever, length of stay was （7.55 ± 0.68） days; and the differences were statistically significant as compared with the TAH group （P〈0.05）. The vaginal stumps were healed in all the patients during the period of follow-up. No abnormal appearances on B ultrasound examinations for pelvic cavity were found. Conclusions LAVH has the common merits of laparoscopy and transvaginal surgery. It is superior to traditional total abdominal hysterectomy and has a greater clinical developing space.